Detailed Abstract
[Presidential Lecture]
[Presidential Lecture] Setting Off to Unchartered World
Ho-Seong HAN*
Department of Surgery, Korea Armed Forces Capital Hospital, Seoul National Univ., Korea
Lecture : One of the most breathtaking innovations in surgery must be the introduction of minimal invasive surgery. When laparoscopic cholecystectomy was first introduced, most of the surgeons have ridiculed new toy-like surgery. Dr. Kurt Semm who performed the first laparoscopic appendectomy and Dr. Erich Muhe who performed first laparoscopic cholecystectomy, have met criticism and censor rather than accolades. For several years, many pioneers of laparoscopic surgery have endured criticism and ridicule and their papers were refused by established journals. Then, after the time passed, the surgical community was being swept by a tidal wave of enthusiasm in minimally invasive surgery Although minimal invasive surgery has become good treatment now, there have been long and rough ways to pass through. Until oncologic safety is shown, the surgery was not well indicated or even contraindicated. Although, cholecystectomy was the first operation performed by laparoscopy, HBP field was among the last where laparoscopy was commonly accepted. HBP malignancy is the area where laparoscopy cannot penetrate through well. After encouraging reports on multicenter randomized study on laparoscopy vs. open procedure on colon cancer has been published, the possibility of oncologic safety in other fields including HBP malignancy could be anticipated. Then the small numbers of the report on minimal invasive surgery for HBP malignancy have started to appear. The field of HBP surgery can be divided into Liver, Pancreas and Biliary field. In minimal invasive liver surgery, first consensus meeting has been very important landmark. Laparoscopic left lateral sectionectomy was considered as standard procedure in this consensus meeting. After the meeting reports on this procedure has been dramatically increased. Although, there has been a surge for this operation, there is also a criticism that the operation is inferior to open surgery. Our group has tried to show that minimal invasive surgery is as meticulous as open surgery by reporting various kinds of anatomic resection one by one. For minimal pancreas surgery, laparoscopic distal pancreatectomy was accepted as good procedure in early period. Replacing open surgery by laparoscopy for distal pancreatectomy give us a distinctive advantage, more spleen saving operations. For spleen saving distal pancreatectomy, splenic vessels preservation has a merit because splenic complication can be maintained minimal. Our groups tried to propagate spleen and splenic vessels preserving distal pancreatectomy. Laparoscopic PD is still a technically challenging procedure. Fifteen years ago, our group started laparoscopy PD in Korea. Although, met with difficulty due to inadequate development of equipment at the time, laparoscopic PD is becoming more and more used than before. Robot-assisted PD can be a good option for minimal invasive PD. The laparoscopic surgery for biliary tract malignancy is still in early stages. The laparoscopic surgery for gallbladder cancer is still not well indicated. Our groups have reported encouraging results after laparoscopic approach for gallbladder cancer. We expect that laparoscopic surgery for gallbladder cancer will be more propagated in the future. The laparoscopic surgery for Klatskin tumor is still experimental procedure. However, this field will be also expected to develop with the new tide of robot and better equipments.There is nothing, which doesn’t change. Laparoscopic surgery in HBP filed is still evolving and will become mainstay of the treatment of HBP disease.
SESSION
Presidential Lecture
Room A 7/28/2020 10:50 AM - 11:10 AM